Rules decoded: Your child won't be covered in family health insurance if...

When a family member falls ill, it feels as though your whole world is turning upside down, doesn't it? This feeling intensifies when it's your child who's unwell, regardless of their age. Here's something you might not be fully aware of: if you've got family health insurance, it's likely your child is covered. But here's the catch - once they hit the age of 25, they're no longer under your policy's protective umbrella.

Yes, you heard that right. Children who've celebrated their 25th birthday generally don't get to enjoy the benefits of their parent's health insurance plan any longer.

How health insurance guards your family

A health insurance plan acts like a safety net, catching you and your loved ones in times of medical emergencies. If you're nurturing a family or thinking about tying the knot, you'd naturally think about extending this safety net to cover your partner and kids.

"Under health insurance, it's possible to opt for a family floater health plan where you can add your spouse or children by paying an additional premium. This way, the entire family shares the sum insured amongst themselves," explains Vivek Chaturvedi, CMO and Head of Direct Sales at Digit General Insurance.

He adds, "Take, for example, a family of four with a plan that has a sum insured of Rs 10 lakh. Any member, or all of them, can utilise this amount during the year, up to the total insured sum. You can either get an individual policy for your child or add them to your family floater policy. However, the family floater option often comes cheaper since the sum insured is shared."

But, there are age limits

"Most health insurers welcome children in the family floater plan up to the age of 25 years, although this can vary," Chaturvedi notes. So, it's crucial to check with your insurer about the age limit before signing up.

Exceptions to the rule

Pursuing Higher Education: For many young adults, education doesn't stop at 25. Pursuing higher education or specialisation often means needing that safety net for a bit longer. Insurance companies get this and at times offer extensions for those knee-deep in textbooks. Parents, you'll need to show proof of your child's full-time educational endeavours to avail this benefit. However, the child must be unmarried to avail the benefit.

Will your daughter and son get extended time in your policy?

Vivek Chaturvedi sheds some light here, "Irrespective of gender, the usual cutoff is 25 years. But you can always check your policy's fine print or ask your insurer directly."

According to Adhil Shetty, CEO, Bankbazaar.com, "If a child is financially dependent on their parents and meets the criteria set by the insurance policy, they may continue to be covered under the family floater plan even beyond the threshold age limit. Some insurance companies may offer policies or rider options that cater to extending coverage for dependent male children beyond the standard age limits. These options may come with additional premiums or specific conditions."

Some policies offer extensions that cater to specific needs, such as covering unmarried or divorced daughters beyond the usual age limit in family floater plans. These policies may come with additional terms or higher premiums. You may get customisation plans to accommodate your specific family situations. This could include extending coverage for unmarried or divorced daughters beyond a certain age limit, says Adhil Shetty.

Tying the knot, however, ends their coverage.

What can your child do after attaining 25 years of age?

If your policy puts a cap on your child's coverage as they turn 25 and they're still under your financial umbrella, you can consider an individual health plan. Such plans not only provide tailored coverage for your child but also come with tax benefits under Section 80D of the Income Tax Act.

Once your child steps is financially independent, they no longer need to rely on your policy.

Vivek Chaturvedi suggests getting your policy early. This strategy ensures you're through any waiting periods well before you need the coverage. For those about to marry or starting a family early, certain insurers offer "early start" plans, which are not only cost-effective but also come with perks like maternity benefits.